Lira University Institutional Repository
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Recent Submissions
Access to ART Services: Lived Experiences and Coping Strategies of HIV-Positive Persons With Visual Impairment in Lira District, Northern Uganda
(John Wiley & Sons Ltd, 2025) Acila, Gloria Ketty; Ijorea, Noeline Aju; Kabunga, Amir; Angom, Mercy Joy; Talemwa, Sandra; Ayer, Patrick; Auma, Anna Grace
Background: Despite progress in the HIV/AIDS response, marginalized populations persistently face unique challenges in
accessing essential healthcare services, including antiretroviral therapy. The aim of this qualitative study is to explore and
understand the lived experiences of individuals living with HIV and visual impairment in Lira District, Northern Uganda,
specifically focusing on their access to antiretroviral therapy services. Additionally, the study is aimed at identifying and
analyzing the coping strategies employed by this population in navigating the intersectionality of HIV and visual impairment.
Methods: This qualitative study, conducted in Lira District, Northern Uganda, employed a descriptive phenomenological design.
Thirty in-depth interviews were conducted at Lira Regional Referral Hospital, focusing on individuals living with both HIV and
visual impairment. Data collection involved a semistructured interview guide, addressing key issues derived from a literature
review. Thematic analysis was used for data analysis, guided by Braun and Clarke’s framework.
Results: Participants (N = 30) exhibited diverse sociodemographic characteristics, with ages ranging from 19 to 68 years. A
number of themes emerged during data analysis: individuals developing visual impairment before and after ART initiation.
Emotional challenges, strained relationships, and perceived burdenship were common themes among participants. Limited
understanding of the cause of sight loss and a heightened perceived risk of HIV infection were evident. Challenges in accessing
ART services included transportation difficulties, negative attitudes from healthcare workers, and a lack of trust in community
drug distribution points. Participants employed various coping strategies, including prayers/religion, reliance on social support
networks, denial, acceptance, and community rehabilitation. Positive religious beliefs offered hope, while social support played
a crucial role in adaptation. Community rehabilitation and support were highlighted as instrumental in aiding coping.
Conclusion: Despite awareness about the risk of HIV infection, significant barriers persist in accessing ART services for persons
with visual impairment. Coping strategies underscore the importance of addressing psychosocial aspects. Tailored interventions,
education, and policy changes are imperative to enhance inclusivity and accessibility of healthcare services for this vulnerable
population in Uganda.
Pediatric low-grade glioma in Africa: a baseline study before the implementation of Global Initiative for Childhood Cancer strategies.
(Frontiers in Cancer Control and Society, 2025) van Heerden, Jaques; Esterhuizen, Tonya Marianna; Jbebli, Elhem; Fedhila, Faten; Rhayem, Samar; Chabchoub, Imène; Togo, Boubacar; Van Zyl, Anel; Neethling, Beverley; Thomas, Karla; Charlton, Robyn; Ngcana, Thandeka; Naidu, Gita; du Plessis, Jan; Nyeko, Richard; Balagadde-Kambugu, Joyce; Hessissen, Laila; Zeyad, Abdel Aziz; Gamal, Aya; Amany, Mohamed Ali; Hamdy, Rana; Asfour, Hosam Y.; Elayadi, Moatasem; Geel, Jennifer; Parkes, Jeannette; Davidson, Alan
Introduction: Pediatric low-grade glioma (LGG) is a World Health Organization
(WHO) Global Initiative for Childhood Cancer (GICC) index tumor constituting
up to a third of pediatric central nervous system (CNS) tumors. The
baseline characteristics, survival, and management resources for pediatric LGG in Africa are unknown. We aimed to evaluate the pediatric neuro-
oncology multidisciplinary team resources, epidemiology, and survival outcomes
of pediatric LGG in Africa to document baseline information prior to
GICC implementation.
Methods: The study consisted of two parts: a survey completed by
African pediatric oncology units (POU) to evaluate the local resources and a
retrospective evaluation of data to determine the 5-year overall survival (OS)
for patients under 18 years diagnosed with LGG between 2008 and 2018. Data
were described in frequencies and percentages. Survival was expressed with
Kaplan–Meier curves.
Results: Five-hundred and eighty-eight patients were included from fifteen
POUs in six countries: South Africa (45.9%), Egypt (30.8%), Morocco (12.6%),
Mali (4.4%), Tunisia (3.6%) and Uganda (2.7%). The median age was 4.4 years
(interquartile range 2.4–7.3 years). The most common primary tumor site was
the brainstem (n = 125, 21.3%), the most common histology was pilocytic
astrocytoma (n = 270, 47.5%), the majority of tumors (n = 292, 93%) were
localized, and 40 (6.8%) patients had neurofibromatosis. Complete resection was
obtained in 99 (16.8%) cases, incomplete resection in 179 (30.4%), and no surgery
or biopsy only was performed in 310 (52.7%) cases. One hundred and forty-
seven (25.3%) of the 580 patients with a documented radiotherapy status, were
irradiated, and 320 (54.4%) received chemotherapy. Only 259 (15.3%) patients
received chemotherapy of which the most common chemotherapy regimen was
vincristine-carboplatin (n = 220, 84.9%). The 5-year OS was 90.5% ± 1.6%. The 5-
year OS in Tunisia was 95.1% ± 1.1%, 92.4% ± 2.1% in Egypt, 89.0% ± 3.2% in South
Africa, 70.7% ± 6.7% in Morocco and 66.7% ± 15.7% in Uganda (p < 0.001). Four
of the 41 (9.8%) responding countries reported having pediatric neuro-oncology
subspecialists, and four (9.8%) had national pediatric LGG protocols. In Africa
there is one radiotherapy center per 2,235,125 children and one neurosurgeon
per 304,685 children, with ∼70% of these resources accessible in four countries.
Discussion: Due to several resource challenges and developing treatment
centers, only fifteen pediatric oncology units from six countries participated.
We documented a baseline 5-year OS of 94.9% for LGG in African children.
To obtain an accurate estimation of pediatric LGG survival in Africa, increasing
participation from a wider range of countries, especially poorly resourced
settings, is necessary.
KEYWORDS
Africa, low-grade glioma, children, outcomes, systems, GICC
Towards an Improved Framework for E-Risk Management for Digital Financial Services (DFS) in Ugandan Banks: A Case of Bank of Africa (Uganda) Limited.
(JOURNAL OF INFORMATION AND ORGANIZATIONAL SCIENCES, 2022) Arim, Andrew; Wamema, Joseph
One of the predominant challenges facing banks in low resource countries is the
management of Digital Financial Services (DFS) risks. Many banks are making
worthwhile efforts to boost the factors that make them come on top of the challenges,
unfortunately they have fallen short. This article sought to develop an e-risk
management framework for DFS in Ugandan banks. Design Science Research
paradigm, a mono-method qualitative research method and a case study research
strategy was adopted. Questionnaires, interviews and document review were the main
data collection methods. Findings from this study indicate that banks in Uganda use a
handful of DFS business models and face a number of DFS risks including; talent for
DFS, technology, strategy, governance, product, client acquisition, crime/fraud,
regulation, and agent management among others. Notwithstanding, Ugandan banks
should carefully balance IT spend across customer expectations, improve cybersecurity
and internal process and regularly check its IT security.
Keywords: E-Risk, Digital Financial Services, Digital Risk Management, Bank Risk
Management, Information Security, Cybersecurity
Farmers’ education and food security at the household level in Lira City, Northern Uganda
(International Journal of Development Research, 2024) Akite, Rebecca; Obici, Gilbert; Mwesigwa, David
The study highlights the contribution of Farmers' Education to food security among selected
households in one division of Lira City. The research questions addressed; the contribution of
farmers' Education to food availability, the contribution of farmers' Education to food
accessibility, and the effect of Farmers' Education on food utilization in Amuca Ward. A
descriptive research design was adopted. The findings revealed that males dominated the study
with a youthful population of 40% and were fairly literate though majority of the respondents
(63%) were married, 16% were cohabiting, 9% were widows and 6% were divorced. 50.78%
were farmers, followed by the business community (7.11%) and politicians were just 4.6% and
civil servants were only 3.5%. It was revealed that the lead organizations that conducted farmers'
education were government-aided (25%), followed by non-governmental organizations standing
at 18%, while fellow farmers stood at 7% and private household arrangements at 27% and others
(23%). This demographic made majority of the respondents to believe that continuous farmers
education coupled with timely agri-inputs; and better government policies aimed to support food
security interventions can guarantee household food security in Lira city. Basing on the findings,
we recommended that Lira City pateners with other stakeholders in funding farmer Education
programs and consider extending the program to its peri-urban areas.
Key Words: Farmer education, Food security, Food availability, Food Accessibility, Food utilization.
Unpackaging E-governance within the Perceptive of Community Development: A review of Selected Services in Uganda
(International Journal of Public Policy and Administration, 2024) Ayoma, Godfred; Ajok, Semmy; Amito, Catherine; Obele, Phedru; Okullu, Daniel; Mwesigwa, David
Purpose: This study aimed to review the relationship between e-governance and local community
development by specifically, focusing on four selected services, viz., universal education, youth
welfare, reproductive health and agricultural development in Uganda.
Methodology: The study took a review of obtainable secondary literature by specifically looking
at online materials both published works such as journal articles, policy statements, statistical
reports as well as annual and/or quarterly reports. The choice of secondary literature, organized
thematically, provided a wider purview of the scattered, yet vital aspects, pertaining e-governance
in social service delivery.
Findings: The outcomes, from the review, indicate that Uganda has made several in-roads
regarding universal primary education, youth welfare programs, reproductive healthcare services
and agricultural development through various interventions aided by e-governance platforms.
However, a number of systemic and structural challenges continue to pull-back national and local
efforts especially seen from online mechanisms.
Unique contribution to theory, practice and policy: This review contributes immensely to the
modern community transformation mooted in a digital era where enabling policies and practices
can benefit from by reversing the impingements as well as the consolidating the success stories.
We encourage the need for government to prioritize lowering the cost of internet services as a way
of enhancing local community development; government should make sure that schools offering
universal education should be facilitated with functional computer laboratories; government
hospitals, at district level, should have a computer laboratory for data storage; and handy apps for
farmers should be given priority so as to enhance smart agricultural development.
Key words: E-Governance, Universal Education, Youth Welfare, Reproductive Health,
Agricultural Development